摘要
目的观察全身麻醉与椎管内麻醉对大隐静脉曲张手术患者体温、脉搏氧灌注指数和凝血功能的影响.方法选择2016年1月至2017年12月嘉兴市第一医院择期行大隐静脉曲张手术的患者60例,采用随机数字表法分为全身麻醉组(G组,n=30)和椎管内麻醉组(I组,n=30).分别记录患者一般情况,手术时间,实施麻醉前(T0)、麻醉后10 min(T1)、20 min(T2)、30 min(T3)核心温度(鼓膜温),相应时间点未输液上肢的脉搏氧灌注指数(PI);于麻醉实施前(T0)及术毕(T4)抽取静脉血分析血栓弹力图(TEG)以观察凝血功能的改变.结果两组患者T1、T2、T3时核心体温较T0时均明显降低(FG=58.789,P=0.000;FI=2.965,P=0.035),且G组降低程度大于I组(t1=-2.998,t2=-5.985,t3=-7.705;P<0.05);T1、T2、T3时PI较T0时均明显增大(FG=5.439,P=0.002,FI=3.404,P=0.020),且G组增大程度大于I组(t1=2.065,t2=2.041,t3=2.649;P<0.05);G组患者TEG检查术毕R时间明显延长(F=5.482,P=0.023),I组患者TEG检查前后未见明显改变.结论全身麻醉下患者体温下降及PI增大更明显,且会造成TEG中R时间指标延长,而椎管内麻醉对凝血功能无明显影响.
Objective To observe the effects of general anesthesia and intravertebral anesthesia on the patients'temperature,perfusion index(PI)and coagulation function.Methods From January 2016 to December 2017,60 patients in the First Hospital of Jiaxing undergoing elective line of great saphenous varicose veins surgery were selected.According to the random number table,the patients were divided into the general anesthesia group(group G,n=30)and intraspinal anesthesia group(group I,n=30).The general condition,operation time,the core temperature(tympanic membrane temperature)before anesthesia(T0),10 min after anesthesia(T1),20 min later(T2),30 min later(T3),and the PI with no-infusion upper limb were recorded.The changes of coagulation function before anesthesia(T0)and after surgery(T4)were observed by extraction of the thrombus(TEG).Results The core body temperature of T1,T2 and T3 was significantly decreased in both two groups(FG=58.789,P=0.000,FI=2.965,P=0.035),and the hypothermia of group G was greater than that of group I(t1=-2.998,t2=-5.985,t3=-7.705;P<0.05).The PI of T1,T2 and T3 was significantly higher than T0 in both two groups(FG=5.439,P=0.002,FI=3.404 P=0.020),and the increase of group G was greater than that of group I(t1=2.065,t2=2.041,t3=2.649;P<0.05).In group G,TEG examination was significantly prolonged(F=5.482,P=0.023),and no significant changes were observed in group I.Conclusion The hypothermia of the patients and the increase of PI increased significantly,and the R time index of TEG is prolonged,and the anesthesia in the spinal canal has no obvious effect on the coagulation function.
作者
刘珂
来岚
丁勤华
陆雅萍
罗永香
高洁彦
Liu Ke;Lai Lan;Ding Qinhua;Lu Yaping;Luo Yongxiang;Gao Jieyan(hejiang Chinese Medical University,Hangzhou Zhejiang 310053,China;Department of Anesthesiology,the First Affiliated Hospital of Jiaxing Medical College,Jiaxing,Zhejiang 314000,China)
出处
《中国基层医药》
CAS
2019年第22期2756-2759,共4页
Chinese Journal of Primary Medicine and Pharmacy
基金
浙江省嘉兴市科技计划项目(2016BY28002)。
关键词
麻醉
全身
椎管内麻醉
大隐静脉曲张手术
体温
鼓膜温
脉搏氧灌注指数
凝血功能
血栓弹力图
Anesthesia
general
Intravertebral anesthesia
Operations on great saphenous vein varices
Temperature
The tympanic membrane temperature
Perfusion Index
Coagulation function
Thrombologram
